2.4.4 Laboratory Analysis

Group A subjects attended two sessions and had two urine specimens, two LP specimens, and an
SP collected. To assess the potential correlation between LP drug test results and those of urine
and SP, the U1, U2, and SP specimens were screened for all drugs, and the presumptive positive
specimens were confirmed for the suspected drug by MS. The screening and confirmation
methods just discussed were used. The LP specimen volumes were insufficient to screen for all
drug classes and to confirm the presumptive positive results by MS. Therefore, we performed MS
confirmations on the LP specimens for those cases in which either the U1, U2, or SP specimen
screened positive for one or more drugs. In addition, we randomly selected 25 cases where both
the urine and SP screening results were negative and performed drug screens on both the LP1 and
LP2 specimens. Confirmations were not performed on these specimens due to the limited LP
volumes.

Group B subjects attended one session and had one urine and one LP specimen collected. To
assess the utility of LP as a screening specimen, the urine and the LP specimens from group B
subjects were screened for the target drug classes. In addition to the standard menu of LP screens,
the LP specimens were tested by EIA using both an amphetamine targeted EIA and a
methamphetamine targeted EIA. The methamphetamine cutoff concentration was 5 ng/mL. No
MS confirmations were performed because the LP volume was insufficient to screen and confirm
all drugs. However, 10 LP samples that screened positive for cocaine were randomly selected for
confirmation of that drug.

3. RESULTS

3.1 Characteristics of Liquid Perspiration Collection
3.1.1 LP Collection Rates and Volume

Based on session one data (first session for group A and only session for group B), LP
collections took an average of 24.2 min (median = 25 min) and resulted in a mean collection of
85.5 L (median = 71 pL) of sweat. The mean rate of LP collection was 3.92 L/min (median =
3.23 L/m). For group A, there was no significant difference between the first and second
session collection times, volumes of LP collected, or the rates of collection (t-tests).

3.1.2 Demographic Differences in Amount of Sweat Collected

In both first and second sessions, there were significant gender differences in the rate of LP
collection. In the first session, males produced LP at the rate of 4.23 L/min and females at the
rate of 2.50 pL/min (¢{149.65]=5.51, p < .001). In the second session, males produced LP at a
rate of 4.48 L/min and females at 2.35 L/min (¢[65.86] = 4.51, p < .001). There was a weak
correlation between level of education and rate of LP collection (Spearman’s rho [209]=0.20,
p<.01). There were no significant differences in LP collection rates based on age. Ethnicity was
not considered independently because there were too few White and Latino subjects.

12


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33


Appendix Group A

29


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38


collection were not significantly different. In addition, the unpleasantness experienced during
collection did not differ significantly. However, subjects tended to rate urine as the most
embarrassing collection procedure (Crouch, et al., 2002).

LP specimens collected with the commercial Macroduct system typically took about 30 min, and
approximately 60 pL was collected. Because it was important to keep the collection time to a
minimum for criminal justice practitioners and donors, and to maximize the volume of LP
collected, alternative methods were explored to increase the rate of LP collection. Those included
increasing the pilocarpine concentration in the induction disks, increasing the induction voltage,
using more than one collection device, and modifying the collection device. Under subcontract,
the manufacturer developed a modified collector with larger induction and collection surface
areas. During the pilot study, LP volumes collected with the standard collector ranged from

0 pL to 85 wL (the maximum capacity) with a mean of 36.4 pL and a median of 33.5 pL. With the
modified collector, specimen volumes ranged from 0 pL to 199 pL with an average of 79.3 pL
and a median volume of 71.0 pL.

Methods were developed and validated using enzyme immunoassay (EIA) to screen the LP
specimens for tetrahydrocannabinol (THC), cocaine, opiates, phenylcyclidene (PCP),
amphetamine, and methamphetamine. The cutoff concentrations are shown in table 1 below.
Considerable effort went into selecting and validating the methods due to the small volumes of LP
available for testing and the very low cutoff concentrations needed for effective testing. In
addition to selecting a suitable screening technique for testing the LP, the study developed and
validated methods to confirm and quantify drug(s)/metabolite(s) in LP. The most promising MS
technologies, such as chemical ionization, gas chromatograph/mass spectrometer (GC/MS), and
liquid chromatography/mass spectrometry/mass spectrometry (LC/MS/MS), were evaluated.
Summaries of the methods developed for LP confirmation testing are shown in table 2.

Table 1. Summary of LP testing cutoff concentrations*

Cocaine PCP THC/COOH**|_Amp/Meth*** Opiates
Screen Cutoff
(ng/mL) 5 <5 5 5 <5
Confirmation
Cutoff (ng/mL) 0.5 0.25 1 20 1

* The available immunossays were established to determine their limit of sensitivity in sweat
in selecting these cutoffs.

** Tetrahydrocannabinol carboxylic acid.

*** Amphetamine and methamphetamine.


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48


Group B Urine Drug Screen Results

CHT Sample # COC/BZE Opiates THC-COOH Pcp AMP/METH
NIST 236 UX neg neg neg neg neg
NIST 237 UX neg neg neg neg neg
NIST 238 UX neg neg neg neg neg
NIST 239 UX neg neg neg neg neg
NIST 240 UX neg neg neg neg neg
NIST 243 UX neg POSITIVE neg neg neg
NIST 245 UX neg neg neg neg neg
NIST 247 UX neg neg neg neg neg
NIST 248 UX neg neg neg neg neg
NIST 249 UX neg neg neg neg neg
NIST 250 UX neg neg neg neg neg
NIST 251 UX neg neg POSITIVE POSITIVE neg
NIST 252 UX neg neg neg neg neg
NIST 253 UX neg neg neg neg neg
NIST 254 UX neg neg neg neg neg
NIST 257 UX neg neg neg neg neg
NIST 259 UX neg neg neg neg neg
NIST 260 UX neg neg neg neg neg
NIST 262 UX neg POSITIVE neg neg neg
NIST 263 UX neg neg POSITIVE neg neg
NIST 268 UX neg neg neg neg neg
NIST 270 UX neg neg neg neg neg
NIST 273 UX neg neg neg neg neg
NIST 274 UX POSITIVE neg neg neg neg
NIST 283 UX neg neg neg neg neg
NIST 286 UX neg neg neg neg neg
NIST 287 UX neg neg neg neg neg
NIST 288 UX neg neg neg neg neg
NIST 289 UX neg neg neg neg neg
NIST 295 UX POSITIVE neg neg neg neg
NIST 303 UX neg neg neg neg neg
NIST 304 UX neg neg neg neg neg
NIST 305 UX neg neg neg neg neg

n=81

46



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52


Appendix Group B

44


If drugs were detected in a subject’s urine or SP, the LP specimens were analyzed by MS. Table
6 shows that when cocaine was detected in U1 or U2, the corresponding LP contained cocaine.
For opiates, there was also 100 % agreement between the U1 and U2 screen positive specimens
and the LP positive results (urine positive/LP positive + urine positive/LP negative categories).
The results for cannabinoids show that they were confirmed in only a single session one LP
specimen, while they were detected in 5 urine specimens. Cannabinoids were not detected in any
session two LP specimens, but were detected in 5 session two urine specimens. For PCP, there
was 100 % agreement between the U1 and U2 screen positive results and the corresponding LP
positive results. No amphetamines were detected in the urine specimens from either session.
However, they were detected in a LP specimen from each session (urine negative/LP positive).
The striking finding was that drugs were often detected in the LP, but not in the corresponding
urine specimen (urine negative/LP positive). For cocaine in session one, the positive rate was
more than 3 times greater in LP than urine (23/7). The session two cocaine results show that at
least twice as many (25/11) subjects would have been identified as cocaine users from the LP
data than from conventional urinalysis. Session one and two opiate results show that nearly
twice (9/5) as many subjects would have been identified as opiate users by LP as through
urinalysis. Cannabinoid use was more likely to be detected through urinalysis than LP testing.
PCP use was detected at equal rates in urine and LP. In both sessions one and two, one LP
sample tested positive for amphetamines that tested negative by urinalysis.

Table 6. Group A positive urine vs. positive liquid perspiration results

Cocaine Opiates THC/THCCOOH PCP Amphetamines
Urine 1 and LP 1
Urine positive/LP positive 7 5 1 1 0
Urine negative/LP positive 16 4 0 0 1
Urine positive/LP negative 0 0 4 0 0
Other (No urine data) 1 0 0 0 0
Total cases 24 9 5 1 1
Urine 2 and LP 2
Urine positive/LP positive 11 4 0 1 0
Urine negative/LP positive 14 3 0 0 1
Urine positive/LP negative 0 0 5 0 0
Other (No urine data) 1 2 1 ) 0
Total cases 26 9 6 1 1

SP specimens were screened for drugs and the presumptive positive results were confirmed by
MS. Table 7 compares the urine drug screening results with the SP analyses. The results for
cocaine are similar to those of LP vs. urine. Cocaine or metabolite was detected in the SPs at a
rate approximately 2.4 times (29/12) that of urine. A similar rate (2.5 X) (15/6) was also
observed for the detection of opiates in SPs vs. urine. In addition, cocaine and opiate positive
samples were rarely missed by SP analysis (urine positive/SP negative). However, cannabinoid
use was more likely to be detected through urinalysis than by SP testing. One subject was
identified as PCP positive by urinalysis who was not detected by SP testing. No confirmed
positive amphetamines were found in the urine or SP.

16


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0001<4Z8/¢Z=000 Seu Seu eu Seu BAILISOd = ZN Z8Z LSIN

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sjuawwiod HLAaW/dNV dod HOOO-OHL sayeido 3Zg/900 _# dl aidwes

Asewwing vojewsyuo0g euuin y dnoig

34


FOREWORD

The Office of Law Enforcement Standards (OLES) of the National Institute of Standards and
Technology (NIST) furnishes technical support to the National Institute of Justice (NIJ) program
to strengthen law enforcement and criminal justice in the United States. OLES’s function is to
develop standards and conduct research that will assist law enforcement and criminal justice
agencies in the selection and procurement of quality equipment.

OLES is: (1) Subjecting existing equipment to laboratory testing and evaluation, and (2)
conducting research leading to the development of several series of documents, including
national standards, user guides, and technical reports.

This document covers research conducted by OLES under the sponsorship of the NIJ.
Additional reports as well as other documents are being issued under the OLES program in the
areas of protective clothing and equipment, communications systems, emergency equipment,
investigative aids, security systems, vehicles, weapons, and analytical techniques and standard
reference materials used by the forensic community.

Technical comments and suggestions concerning this report are invited from all interested
parties. They may be addressed to the Office of Law Enforcement Standards, National Institute
of Standards and Technology, 100 Bureau Drive, Stop 8102, Gaithersburg, MD 20899-8102.

Kathleen M. Higgins, Director
Office of Law Enforcement Standards

iii


P. Kintz, A. Tracqui, C. Jamey, and Mangin, “Detection of Codeine and Phenobarbital in Sweat
Collected With a Sweat Patch.” J. Anal. Toxicol., 20, 197 (1996).

T. Mieczkowski, H. Landress, R. Newel, and S. Coletti, “Testing Hair for Illicit Drug Use.” NIJ
Research in Brief, Washington, DC: U.S. Department of Justice (1993).

T. Mieczkowski and K. Lersch, “Drug Testing in Criminal Justice: Evolving Uses, Emerging
Technologies.” NIJ Journal, December 1997.

National Institute of Justice, The Future of Drug Testing. Meeting in Washington, DC,
March 6-7, 1996.

C.L. O’Neal, D.J. Crouch, D.E. Rollins, and A.A. Fatah. “The Effects of Collection Methods on
Oral Fluids Codeine Concentrations.” J. Anal. Tox., 23, 436-452, October 2000.

B.A. Reaves (1992). Drug Enforcement by Police and Sheriff's Departments,” (1990). BUS
Special Report, Washington, DC: U.S. Department of Justice.

Package Inserts, STC Diagnostics, Bethlehem, PA 18018, February 1996.

Package Inserts, STC Technologies, Inc., Bethlehem, PA 18018. Cannabinoids, August 1997;
Methamphetamine, January 1997; Opiates, January 1997 and PCP, December 1996.

S. Turner, J. Petersilia, and E. Deschenes, “The Implementation and Effectiveness of Drug
Testing in Community Supervision: Results of An Experimental Evaluation.” In D.L.
MacKenzie and C.D. Uchida (Eds.), Drugs and Crime: Evaluating Public Policy
Initiatives. Thousand Oaks, CA: Sage Publication (1994).

C. Visher, “Pretrial Drug Testing.” NIJ Research in Brief, Washington, DC: U.S. Department of
Justice (1992).

L. Webster and W. Barlow, “New Approach to Cystic Fibrosis Diagnosis by Use of an Improved
Sweat-Induction/Collection System and Osmometry. Clin. Chem., 27, 385 (1981).

G. Yacoubian, E. Wish, and D. Perez, “A Comparison of Saliva Testing to Urinalysis in an
Arrestee Population.” J. Psychoactive Drugs, 33, 289 (2002).

27


3.1.3 Participant Attitudes Toward the LP Collection Procedure

Participants were asked to rate the “discomfort,” “unpleasantness,” “duration,” and
“embarrassment” of the urine, LP, and sweat patch collection procedures. Unpleasantness was
rated on a 0 to 3 scale; the other perceptions were rated on 0 to 2 scales, with “0” being most
negative. Data were analyzed separately for first and second session collections.

Repeated measures of the analysis of variance (ANOVA) of first session ratings showed
significant differences between the LP and urine collections on all measures. Subjects reported
being significantly more comfortable during the LP collection (mean = 2.01) than the urine
collection (mean = 1.68), ¢[199] = 4.27, p < .001). Subjects reported fewer unpleasant feelings
with the LP (mean = 1.61) compared to the urine collection (mean = 1.39), [201] = 3.51,

p <.001. Subjects were less embarrassed by the LP collection (mean = 1.90) than by urine
collection (mean = 1.51), ¢[199] = 7.57, p < .001. However, the urine collection was perceived to
take significantly less time (urine mean = 1.72, LP mean = 1.45), ¢[200] = -4.89, p <.001.

Repeated measures of the ANOVA of the second session perceptions showed significant
differences similar to those observed in session one. The subjects rated LP and SP similar to each
other for the measures. However, the LP and SP ratings were significantly different from the
urine collection ratings. Subjects were significantly more comfortable with the LP (mean = 2.04)
and SP (mean = 2.01) procedures than the urine collection procedures (mean = 1.77),

F [2,168] = 6.04, p < .003. The respondents reported experiencing fewer unpleasant feelings
with the LP (mean = 1.72) and SP collections (mean = 1.73) than with the urine collection (mean
= 1.46), F [2,168] = 9.63, p < .001. In addition, the subjects reported that they were less
embarrassed by the LP (mean = 1.91) and SP collection (mean = 1.94) than by urine collection
(mean = 1.55), F [2,168] = 22.83, p < .001. As with the first session results, the urine collection
was perceived to take significantly less time (mean = 1.77) than either the LP (mean = 1.52) or
SP collection (mean = 1.42), F [2,166] = 11.42, p< .001.

A comparison of the ratings for the LP and urine collections between the first and second
sessions demonstrated no significant differences. Therefore, the subject’s attitudes about the
collection procedures did not change significantly between sessions one and two. (Note: there
were no SP collections at the first session).

3.2 Self-Reported Drug Use
The questionnaire included a drug use section that required the subjects to report if they had used
marijuana, cocaine, heroin, or hallucinogens during the previous 30 d. The percentages of

subjects reporting using/not using the drugs at the first and second sessions are shown in tables 3
and 4.

13


for each drug. As shown, the urine group B positive rates varied from 1.2 % for amphetamines to
12.1 % for cocaine.

An LP specimen was collected from each of the 115 subjects recruited for group B. Each of
those specimens was analyzed at CHT using the validated ELA screening methods described.
Unfortunately, the cocaine EIA analysis performed poorly and nearly all (87.8 %) of the LP
specimens tested positive. These data should not be considered representative of the prevalence
of cocaine in the subjects, but rather a failure of the commercial EIA test kit. As shown, the LP
positive rate for opiates was approximately 3 times that of the urine rate. No LP samples
screened positive for cannabinoids. The positive rates for PCP were roughly equivalent in urine
and LP. However, the LP positive rate for amphetamines was approximately 10 times the urine
positive rate. This was partially attributable to screening the LP amphetamines using both
amphetamine and methamphetamine specific EIA kits (see methods—urine was screened using
only one kit). Five additional LP positive specimens were identified using the additional
methamphetamine testing (4.3 %).

Table 10. Summary of group B urine and liquid perspiration specimens
received and screened positive

Urine Cocaine Opiates THC/THC- PCP Amphetamines
COOH
Number of Samples 115 115 115 115 115
Number, no data 8 8 10 20 29
from PT
Number screened at 107 107 105 95 86
CHT
Number positive 13 8 6 4 1
% Positive 12.1% 7.5% 5.7% 42% 1.2%
LP
Number of Samples 115 115 115 115 115
Number, no data NA* NA NA NA NA
from PSA
Number screened at 115 115 115 115 115
CHT
Number positive 101 27 0 4 16
% Positive 87.8% 23.5% 0.0 % 3.5% 13.9 %
*Not applicable.

An important aspect of this research was to determine if LP was a suitable specimen to use for the
detection of drug use by subjects in the criminal justice system. Table 11 shows a comparison of
the urine and LP results for the group B subjects. The table shows that when a subject’s urine
tested positive for cocaine, opiates, or PCP, the LP also tested positive (100 % agreement).
However, when a subject’s urine tested positive for cannabinoids, they were not detected in
his/her LP (0 % agreement). There was also good agreement between the urine testing negative
and the associated LP testing negative for all drugs except cocaine (> 80 % agreement). For

19


For U1, screening data were not available for between 2 and 12 subjects/drug. As shown, the
adjusted U1 positive rates varied from 0.0 % for amphetamines, to a high of 9.2 % for cocaine.
For U2, screening data were not available for between 3 and 26 subjects/drug. The majority of
the missing data were for amphetamines, which is not a priority analysis at PSA. As shown, U2
positive rates varied from 0.0 % for amphetamines to a high of 12.8 % for cocaine. The relative
order of the positive rates for U1 and U2 were the same: cocaine>cannabinoids>opiates
>PCP>amphetamines. The positive rates for each drug in U1 and U2 were also similar except for
cocaine (9.2 % vs. 12.8 %).

Of the 89 group A subjects, six did not provide a SP for analysis. Therefore, 83 SP specimens
were analyzed at CHT. As shown, the SP positive rates varied from a low of 0 % for PCP to a
high of 38.6 % for cocaine. The rates for cocaine, opiates, and amphetamines exceeded those of
U1 and U2. The SP positive rates for cocaine and opiates were approximately 4 times those of U1
or U2. However, the positive rates for PCP and cannabinoids were less than those of U1 and U2.

Table 5. Summary of group A urine and sweat patch specimens received, tested,

and % positive by drug
THC/THC-

\Urine #1 Cocaine Opiates COOH PCP Amphetamines
[Number of samples 89 89 89 89 89
[Number with data lacking 2 2 7 5 12
|Number screened 87 87 82 84 77
Number positive 8 5 5 1 0
% Positive 9.2% 5.7% 6.1% 1.1% 0.0 %
Urine #2
[Number of samples 89 89 89 89 89
[Number with data lacking 3 3 9 12 26
|Number screened 86 86 80 77 63
Number positive 11 4 6 1 0
% Positive 12.8% 47% 75% 12% 0.0 %
Sweat Patch
Number of samples 89 89 89 89 89
Number of patches not received 6 6 6 6 6
Number screened 83 83 83 83 83
[Number positive 32 18 1 0 6
% Positive 38.6%  .21.7% 1.2% 0.0 % 7.2%

15




lengthiness of collection, unpleasant sensations, and embarrassment. Ratings were made on a 3-
point scale (0 to 2), with 0 being the most negative response. Participants were also asked which
procedure they liked most and which they liked least. The final section of the questionnaire asked
participants to report how frequently they had used a variety of illicit drugs in the last 30 d, and
how recently they had used the drugs. Participants were asked to rate the sweat patch procedure
only at session two, when the patch was harvested.

Group A participants were scheduled to return approximately one week later for session 2
specimen collections. Participants were told that they would again receive the incentive ($20) for
completing session two.

Urine specimens were collected from most subjects. However, many subjects had just provided a
specimen for the PSA. For these subjects, an aliquot was obtained from the agency’s specimen. In
approximately 1/3 of the subjects, no aliquot was available. Therefore, the PSA provided their drug
screening results for these subjects. In group A, 126 urine (screen results were provided for 35
additional specimens), 83 sweat patch, and 177 LP specimens were collected. In group B, 81 urine
(screen results were provided for 34 additional specimens) and 115 LP specimens were collected.

2.4.1 Sample Characteristics

The sample was mostly male (73 % male, 27 % female), African American (97.3 % African-
American, 1.8 % White, and 0.9 % Hispanic/Latino), with a mean age of 39.1 years. The
educational level of the majority of the subjects was high school graduate (38.5 %) or less (38 %).
Less than 1/5 (19 %) had attended college, and only 4.5 % were college graduates.

2.4.2. Data and Specimen Handling

All specimens were labeled with study identification numbers to ensure confidentiality and allow
matching of the survey and specimen data. Survey data were processed and analyzed at ISA, and
the biological specimens were analyzed at CHT.

All specimens were treated as biohazards during collection and handling. For shipping, they
were cold-packed and forwarded to CHT via overnight courier. Upon receipt at CHT, the
specimens were segregated into group A and group B specimens and encoded with a unique
intra-laboratory identifier. Urine specimens from group A were identified by session one (U1)
and session two (U2). Similarly, LP specimens from group A were identified by session one
(LP1) and session two (LP2), and the sweat patches as SP. Urine specimens from group B were
identified by “UX” and LP specimens as “LPX.” All specimens were then stored in secure
freezers awaiting analysis. For testing, CHT thawed the specimens and removed an aliquot for
each analysis.

2.4.3 Analytical Methods
Urine specimens were screened by automated laboratory-based EIA using the standard urine
cutoff concentrations: cocaine, 300 ng/mL; opiates, 300 ng/mL; cannabinoids, 50 ng/mL; PCP, 25

ng/mL; and amphetamines, 1000 ng/mL (DHHS, 1993). All presumptive positive specimens
(detected at CHT) were confirmed by MS. Some specimens were tested at PSA with similar

10


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54


1. BACKGROUND

1.1 General

After a brief overview of the project, this section describes the rationale for the project and
reviews pertinent research on drug testing in criminal justice settings.

1.2 Project Overview

Also discussed in this section are the results of a pilot study. The pilot study gathered data on
criminal justice system subjects’ perceptions about the use of the Macroduct, developed drug
testing methods for liquid perspiration (LP), and compared drug test results from urine, the sweat
patch, and LP.

The project began May 1999 and was conducted over a period of three years. Project objectives
were as follows:

© Modify and test innovative, less invasive, liquid perspiration (LP) collection devices.

e Adapt drug screening kits for use in analyzing LP specimens and develop drug
confirmation methods.

e Assess the validity and utility of the LP collection device as a method of drug testing with
criminal justice populations.

e Perform a pilot study to assess the utility of using LP as a testing specimen in a criminal
justice population.

e Perform a field study to fully assess the procedures and evaluate the results of the pilot
study in a criminal justice population.

The pilot and final projects were conducted in conjunction with the Pretrial Services Agency
(PSA) in Washington, DC. This agency, a pioneer in the applications of drug testing to criminal
populations, currently drug tests approximately 155 000 urine specimens annually using an in-
house, high-speed auto-analyzer. The PSA is an ideal field study site because the agency tests
several hundred arrestees daily, the majority of whom test positive for one or more drugs; and the
agency has previously participated in field test trials of innovative drug tests.

1.3 Drug Testing in the Criminal Justice System

Drug testing is widely used throughout the criminal justice system. Major uses include pretrial
drug testing, used to make decisions about probation or pretrial release, and to supervise drug-
involved defendants more closely (Visher, 1992); post-adjudication testing of drug offenders by
probation and parole departments (Turner, et al., 1994); and testing of law enforcement personnel
(Reaves, 1992). In addition to these major programs, drug testing is also a significant element in
drug courts (Goldkemp and Weiland, 1993) and programs designed to assess drug use among
juvenile detainees (Dembo et al., 1990). Moreover, data on the effectiveness of drug testing is
sufficiently supportive that testing is likely to expand throughout the criminal justice system
(Mieczkowski and Lersch, 1997).


The cost of an LP collection is a limitation. The cost of an LP collection using the
modified collector greatly exceeded that of a urinalysis or SP.

The volume of LP collected remains a limitation to its use. The volume is sufficient to
screen for the drugs of abuse or to perform a limited screen and a confirmation of no
more than 1 or 2 drugs. However, the specially engineered collector harvested larger
volumes at a faster rate than the standard collector.

Existing, commercially available, EIA drug screening technologies can be used
effectively to screen for drugs of abuse in LP specimens. However, the EIA kit
selected for use showed a variation in the antibody specificity between the pilot and
field studies for cocaine. However, the confirmed positive rate for a randomly selected
set of EIA specimens that screened positive for cocaine was 50 %.

MS procedures were developed and validated for confirmation of drugs of abuse in
LP.

LP may be a preferable specimen to urine for the detection of drug use by arrestees in
the criminal justice system, specifically, for the detection of cocaine and opiates.
Results show that 2 to 3 times the number of cocaine users and nearly 2 times the
number of opiate users were identified using LP testing. These MS results identified
incidences in which the LP tested drug positive and the corresponding urine specimen
tested negative. Also in a selected number of subjects whose U1, U2, and SP
specimens screened negative, the detection rates of opiate, PCP, and cannabinoids
were 10 %, 4 %, and 4 % respectively, using the LP screening.

LP positive rates for drugs of abuse were similar to the SP. However, LP offers several
advantages as a specimen for testing in the criminal justice system. One does not have
to wait a week between application and harvesting. Therefore, only one visit is needed
to obtain a specimen. The entire LP collection process may be observed by the donor
and the collector—eliminating questions of specimen identity and integrity such as
environmental exposure of the patch to drugs.

The detection rates of cannabinoids, PCP, and amphetamines were too low in the
population to draw conclusions about the detection rates in LP vs. urine or LP vs. the
SP. However, detection rates compared to urine were encouraging.

Further study of LP is needed to fully understand the advantages and limitations of the
specimen and the collection technique. For example, more positive cases for
amphetamine(s), cannabinoids, and PCP are needed to evaluate usefulness of LP for
the detection of these drugs. It is not known whether LP drug concentrations correlate
with blood drug concentrations. This should be examined, because if a correlation
exists, LP would be a very useful specimen in the criminal justice system and criminal
investigations.

25


Table 14. Comparison of self-report and sweat patch specimens

Positive Negative
Self-reported Yes 17 6
30-—d use No 17 39

Note: SP specimen data are screened or MS confirmation data. The later
was used when available.

4. DISCUSSION

This project sought to assess the feasibility of using liquid perspiration (LP) as a specimen for
drug testing in the criminal justice system. The collection of LP was seen as a potentially less
invasive alternative to the current urine-based drug testing methods that are the principal
methods used by virtually all the criminal justice systems in this country. In addition, LP
appeared to have several potential advantages compared to sweat patch testing (also commonly
used in the criminal justice system). The LP collection could be totally observed by the donor
and criminal justice practitioner, concentrations of the drug could be determined, and the
specimen was more easily handled in the laboratory than a sweat patch.

The pilot study results were encouraging and supported the use of LP for criminal justice drug
testing. It demonstrated that an LP collection device could be used to harvest specimens in a
criminal justice setting, that the collection procedure was well tolerated by the subjects, and that
drugs of abuse could be detected in LP specimens using available analytic procedures.

In the pilot study, arrestees appeared to have had few (if any) problems with the data collection
procedures. The recruitment of subjects and the collection of specimens proceeded without any
serious impediments. The management and staff of the PSA were helpful and supportive of the
research project, and most arrestees approached to participate in the research volunteered to do
so. Subjects’ ratings of the different collection procedures indicated that the LP procedures were
perceived as no more discomforting or unpleasant than the urine collection and the sweat patch,
and that the LP procedures were viewed as significantly less embarrassing than the urine
collection. The pilot study identified challenges, both practical and analytic, to the use of the LP
method for drug testing. The 25 min to 30 min collection time may be inconvenient in many
settings, and the small volume of LP collected posed significant technical difficulties in the
analysis; both issues received considerable attention in the study design of the main field study.
Because the results indicated that the larger, specially engineered collector was capable of
collecting larger volumes at a faster rate than the standard collector, the modified (and similarly
modified devices) was used in the field test.

Substantial strides were made in the development and validation of the analytic methods for
screening and confirmation of drugs in LP specimens. With a single exception, all of the
methods developed in the pilot study performed well when used to test the urine, LP, and SP
specimens in the field study. However, pilot study success with the EIA screening LP for cocaine
was not duplicated in the field study. About 88 % of the LP specimens in group B screened

22


FOREWORD
COMMONLY USED SYMBOLS AND ABBREVIATIONS.
1.

CONTENTS

BACKGROUND
1.1 General...
1.2 Project Overview
1.3 Drug Testing in the Criminal Justice System
1.4 Sweat Testing
1.5 Pilot Study....

2. METHODOLOGY
2.1 Introduction.
2.2 Site Preparation:
2.3 Selection of a Collection Devic:
2.4 Data Collection Procedures.

3. RESULTS wu. eeceseeeeesseees
3.1 Characteristics of Liquid Perspiration Collection. 12
3.2 Self-Reported Drug Use......... 13
3.3. Results: Biological Specimen: 14
3.4 Comparison of Results from Self-Reports and Biological Specimens

4. DISCUSSION

5. CONCLUSIONS

6. REFERENCES...

APPENDIX GROUP A .

APPENDIX GROUP B..

Table 1. Summary of LP testing cutoff concentrations
Table 2. Summary of LP confirmation methods.
Table 3. Percentage of subjects reporting using/not using drugs

TABLES

Table 4. Percentage of subjects reporting using/not using drugs at session two
Table 5. Summary of group A urine and sweat patch specimens received, tested,

and % positive by drug
Table 6. Group A positive urine vs. positive liquid perspiration results . 16
Table 7. Group A positive urine vs. positive sweat patch results........ 17
Table 8. Group A positive liquid perspiration vs. positive sweat patch results. 17
Table 9. Group A liquid perspiration screen results for a sample of cases with

Negative ULINE SCTEENS .........sseseeseeseeseeseesereeseesseneenessesteseesseenesnenseseensateneeneneenententeneees 18

Table 10. | Summary of group B urine and liquid perspiration specimens received

Table 11. Group B liquid perspiration screen results vs. urine screen result:
Table 12. Comparison of self-report and urine specimens
Table 13. Comparison of self-report and liquid perspiration specimens
Table 14. | Comparison of self-report and sweat patch specimens

and screened positive





screening methods, however, aliquots of those specimens were not always available for
confirmation (see above). Urine confirmations were performed by LC/MS. Each confirmation
batch contained a drug-free sample and multiple calibrators. One milliliter aliquots of each
presumptive positive specimen, calibrator, or quality control samples were processed. Deuterium
labeled internal standards were added to each sample for qualitative drug identification by relative
retention time and for quantitation of the analyte. Urine confirmation cutoff concentrations were
cocaine, 25 ng/mL; opiates, 10 ng/mL; cannabinoids, 50 ng/mL; PCP, 5 ng/mL; and
amphetamines, 25 ng/mL. A cocaine confirmation consisted of analyzing for cocaine and
benzoylecgonine. An opiate confirmation included morphine, codeine, and 6-acetylmorphine. For
cannabinoids, urine specimens were analyzed for the presence of THC-COOH. An amphetamines
confirmation included methamphetamine, amphetamine, methylenedioxymethamphetamine
(MDMA), methylenedioxyamphetamine (MDA), and methylenedioxyethylamphetamine
(MDEA).

Sweat patches (SPs) were eluted with 2.5 mL of buffer and screened by EIA to the following
cutoff concentrations: cocaine, 5 ng/mL; opiates, 5 ng/mL; cannabinoids, 1 ng/mL; PCP, 5 ng/mL
and amphetamines, 10 ng/mL (STC, 1996 and 1997). All presumptive positive SPs were
confirmed by LC/MS for all drugs except the cannabinoids (GC/MS). Procedures were analogous
to the urine confirmation procedures — each batch contained a drug-free sample and multiple
calibrators and 1 mL aliquots of each presumptive positive specimen, calibrator, or quality control
samples was extracted. Deuterium labeled internal standards were added to each sample for
qualitative identification of the drug or metabolite and for quantitation. The SP confirmation
cutoff concentrations were cocaine, 5 ng/mL; opiates, 5 ng/mL; cannabinoids, 1 ng/mL; PCP, 5
ng/mL; and amphetamines, 10 ng/mL. A cocaine confirmation consisted of analyzing for cocaine
and benzoylecgonine. An opiate confirmation included morphine, codeine and 6-acetylmorphine.
For cannabinoids, the SPs were analyzed for both THC and THC-COOH. An amphetamines
confirmation included methamphetamine, amphetamine, MDMA, MDA, and MDEA.

As discussed, specific methods were developed and validated during the pilot study for the
analysis of the LP specimens (Crouch, 2002). Two promising laboratory-based immunoassays
were selected for evaluation: enzyme immunoassay (EIA) and radioimmunoassay (RIA).
(STC, 1996 and 1997; and Fay, et al., 1996). The EIA test kits showed more promise for drug
detection in LP than RIA, especially for the detection of THC, THC-COOH, codeine, and
morphine. The EIA screening cutoff concentrations and target analytes for LP are shown in the
table presented previously.

The LP analyses by MS were especially challenging because the volume of LP collected was
typically in microliters and the expected drug concentration (given the pilot study results) were
ng/mL. The LP specimen volumes and drug concentrations are in marked contrast to urine
collections that are typically in excess of 100 mL and urine-drug concentrations that are usually
10 or more times those of LP. Therefore, we developed chemical ionization GC/MS, LC/MS, and
LC/MS/MS methods for the confirmation of the target drugs in LP. Summaries of the methods,
drugs tested for, and cutoff concentrations are shown in tables 1 and 2 above.

11


An Evaluation of Innovative Sweat-Based Drug Testing Techniques for Use in
Criminal Justice Drug Testing- Final Report

Dennis J. Crouch, Jayme Day, Jakub Baudys, University of Utah, Center for Human Toxicology,
Salt Lake City, UT 84112-9457

Introduction

Drug testing is used at all points in the criminal justice system—from pretrial to incarceration.
Results are used to help make decisions about pretrial release, probation, and parole.
Noninvasive drug detection is one of the priority areas of research established by the Law
Enforcement and Corrections Technology Advisory Council (LECTAC). LECTAC reviews and
analyzes the present and future technological needs of the criminal justice system. The Council
uses this information to recommend research and development priorities to NIJ. Its members are
appointed based on their records of distinguished service and include representatives from
Federal, State, local, and international criminal justice agencies and organizations.

To improve the practice of drug testing in the criminal justice system, the National Institute of
Justice (NIJ) funds research into new methods and evaluates the potential of alternative
techniques. Research areas include the use of hair, saliva, and sweat as alternatives to urinalysis
for drug testing. Types of investigation include evaluation of available collection devices,
possible adaptation of such devices for use in the criminal justice system, development of quality
assurance programs and standard reference materials, and improved methods for interpreting test
results. This final report presents the results of the project “An Evaluation of Innovative Sweat-
Based Drug Testing Techniques for Use in Criminal Justice Drug Testing.” This three-year
project was a collaborative effort between the Institute for Social Analysis (ISA), the prime
contractor, and the University of Utah’s Center for Human Toxicology (CHT), the sub-
contractor.

This project assessed the feasibility of adapting a device originally designed to collect liquid
perspiration from infants to test for cystic fibrosis (the Macroduct®)’ for use in criminal justice
settings to test for drug use (as an alternative to urinalysis and the sweat patch). The primary
focus of this report is a comparison of liquid perspiration test results to urinalysis and sweat
patch results, and an assessment of participant’s perceptions of the different collection methods.
Results from both a pilot study and subsequent field study are reported. Both studies were
conducted in collaboration with the Pretrial Services Agency (PSA) in Washington, DC.

The authors would like to acknowledge Wayne Barlow, President; Kent Thomas,
Business Manager; Lewis Webster, Senior Scientist; and Dennis Briscoe, Chief
Engineer from Wescor, Inc., for their assistance to modify the collector, and the
technical assistance provided in this regard. The authors would also like to acknowledge
the cooperation and support of Mr. Jerome Robinson and his staff from the PSA.
Without the support and cooperation of Wescor and PSA, the pilot and field studies
could not have been successfully completed.

“Certain products or materials are identified in this paper to adequately specify the experimental procedure. Such identification does not imply
recommendation or endorsement by the National Institute of Standards and Technology (NIST), nor does it imply that the products are
necessarily the best available for the purpose.


Table 7. Group A positive urine vs. positive sweat patch results

Cocaine Opiates THC/THCCOOH PCP Amphetamines
Urine and Sweat Patch
Urine positive/SP positive 12 6 0 0 0
Urine negative/SP positive 17 9 1 0 1
Urine positive/SP negative ) 0 8 1 0
Other (No urine or SP data) 1 3* 0 0 5**
Total cases 30 18 9 1 6

* PSA data or sweat patch MS confirmation not available.
** Five specimens screened positive, but did not confirm.

If an SP specimen tested positive for a drug, one would expect that either LP1, LP2, or both LP
specimens would also test positive. Table 8 compares the SP results with those of LP1 and LP2.
The results for cocaine show a much better correlation between the positive rates than was
observed in the urine vs. LP, or urine vs. SP comparison. Cocaine or metabolite was detected in
LPI and LP2 in 80 % and 84 %, respectively, of the total number of positive case results (LP
positive/SP positive + LP positive/SP negative categories). However, for both LP1 and LP2, 44%
(7/16) of the positive opiate cases shown in the table were not detected in the LP. The table shows
a limited number of cannabinoid positive results with little difference between the LP and SP
findings. PCP was detected in LP1 and LP2 of one case, when not found in the SP. The SP from
four cases screened positive for amphetamines, but the results were not confirmed by MS.
Therefore, there was little difference between the confirmed LP and SP amphetamines findings.

Table 8. Group A positive liquid perspiration vs. positive sweat patch results

Cocaine Opiates THC/THCCOOH PCP Amphetamines

LP 1 and Sweat Patch

LP positive/SP positive 23 9 0 0
LP negative/SP positive 6 7 1 0 1
LP positive/SP negative 1 ) 1 1 1
Other (No LP or SP

data) t) 0 0 4*
Total cases 30 16 2 1 6
LP 2 and Sweat Patch

LP positive/SP positive 25 9 0 1
LP negative/SP positive 5 7 1 0 0
LP positive/SP negative 1 ) 1 1
Other (No LP or SP

data) 0 0 0 0 4*
Total cases 31 16 1 1 6

* Four specimens screened positive, but did not confirm.

17


NISTIR 7140

An Evaluation of Innovative Sweat-Based
Drug Testing Techniques for Use in
Criminal Justice Drug Testing

- Final Report

Royer F. Cook
David C. Dove

Institute for Social Analysis
Alexandria, VA 22314

Dennis J. Crouch
Jakub Baudys

University of Utah
Center for Human Toxicology
Salt Lake City, UT 84112-9457

Coordination by
U.S. DEPARTMENT OF COMMERCE
Office of Law Enforcement Standards
National Institute of Standards

and Technology
Gaithersburg, MD 20899-8102

NUST

National Institute of Standards and Technology
Technology Administration, U.S. Department of Commerce



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40


and must be graduated by volume. In addition, capillary tube collections rely on having
recognizable liquid perspiration on the skin surface.

Sweat collection devices have been cleared for clinical applications and for drugs of abuse testing.
Sweat may be collected on tamper-proof absorbent patches. The patches are applied to the subject
with a simple adhesive and may be worn for extended periods of time. While the patch is worn,
sweat is absorbed and drug(s) and their metabolite(s) are deposited on the sweat patch pad.
Several studies have been performed to evaluate the efficacy of detecting drug use with sweat
patch testing (Burns and Baselt, 1995; Fogerson, et al., 1997; and Kintz, et al., 1996). These
studies have shown that the patches are particularly useful in criminal justice settings where
constant surveillance through use of the sweat patch has detected drug use that was not detected
by discrete urinalysis tests; and several drugs of abuse such as amphetamine and
methamphetamine, heroin, morphine, methadone, marijuana, and phencyclidine have been
detected in sweat (Baer and Booher, 1994). The patches are also potentially useful in drug
treatment and parole/probation programs where abstinence is used as a measure of treatment
compliance and recidivism can be monitored by having the patient continuously wear a patch.

A limitation of sweat testing is that little is known about the deposition of drugs into sweat;
therefore, interpreting test results can be difficult. For example, the authors do not know the
minimum dose of most drugs that needs to be ingested for the drug(s) to be detected in the patch.
Currently, we cannot predict how long after ingestion drugs of abuse can be detected in liquid
perspiration. The volume of sweat collected by the patch is unknown. This precludes meaningful
(drug/microliter of LP) quantitative analysis of drugs detected and, again, limits the interpretative
value of the results. The cost of sweat patch testing is about the same as urinalysis testing.
However, since drug concentrations are lower and the entire patch is consumed for a single
conformational analysis, repeat testing and confirmation of multiple drugs are precluded.

The Webster Sweat Collection System was introduced in 1978 as one of the first systems
designed to collect LP (Webster and Barlow, 1981). It is currently marketed as the Macroduct and
used to harvest LP from infants for use in the early diagnosis of cystic fibrosis (Carter, et al.,
1984; and Hammond, et al., 1994). The system has been cleared by the Food and Drug
Administration (FDA), and has been designed for use with infants and children. Therefore, it is
extremely safe for both the collector and the donor. The entire system is compact and portable
(9.2 cm x 4.5 cm x 15.5 cm, weighs 0.4 kg) and fits into a carrying case no larger than that used
for a laptop computer. The system consists of pilocarpine discs, a portable power supply that
provides a micro current to induce “iontophoresis,” and the LP collector.

Pilocarpine is a naturally occurring alkaloid that can be extracted from plants. It is used medically
to treat glaucoma, but also stimulates salivation and sweat production. In the LP collection
process, a small electrical current (microamps) promotes transfer of ionized pilocarpine from the
disk through the skin to the sweat glands where it stimulates sweat production. The collector is
attached to the donor's forearm, and a capillary tube fills with LP by hydrostatic pressure.

There are several potential advantages to the use of this collector and LP for drug testing in the
criminal justice system. First, sensible sweat is collected. This LP is actively produced at the time
of collection and, therefore, the drug concentrations may reflect blood drug concentrations. The
collection process can be fully witnessed, thereby ensuring the integrity and identity of the


Currently, most drug testing in criminal justice is based on analysis of urine specimens by
immunoassay (screening) and gas chromatography/mass spectrometry (GC/MS) (confirmation).
Although recently alternative testing techniques such as hair analysis and on-site kits have
become more common (NIJ, 1996), laboratory-based urinalyses remain the “gold standard” by
which other methods are assessed. However, despite its advantages, urine testing involves
collection methods that are invasive—often discomforting to donor and collector alike—and
which typically require burdensome facilities and procedures. It is highly desirable to develop a
practical, cost-effective method of drug testing that is as reliable as urine testing, but less
invasive.

Among the alternative technologies that are in various stages of development are hair,
perspiration, and saliva analyses. Hair analysis is perhaps the most advanced of these technologies
with several commercial laboratories currently performing hair testing. Researchers have begun to
test its efficacy in criminal justice settings (Mieczkowski, et al., 1993). However, because of
potential problems with contamination and hair color bias, the accuracy and utility of hair
analyses remain in question (Cook, et al., 1995; and NIJ, 1996). In principle, the analysis of other
body fluids, such as perspiration and saliva should offer the most promising noninvasive means of
drug testing.

Several devices are now commercially available for saliva testing. However, little is known about
the utility of these devices or how drugs and their metabolites are transferred from blood to saliva.
In addition, immediately after smoking or orally ingesting a drug, the oral cavity may be
contaminated by the drug leading to falsely elevated saliva-drug concentrations. Also, drug
concentrations in saliva appear to vary by method of collection (O’Neal, et al., 2000). Therefore,
among the less invasive methods, sweat testing appears the most promising, and the new LP
collection devices offer a practical and noninvasive means of specimen collection. These devices
are discussed below.

1.4 Sweat Testing

Sweat has been extensively studied as a potential clinical diagnostic fluid. Several sweat
collection methods are described in the literature such as skin blotting, skin wipes, capillary tubes,
sweat patches, and iontophoresis (Kidwell et al., 1998). Techniques such as blotting and skin
wipes often rely on occlusive sweat stimulation and collection. The limb or site of collection is
placed in an impermeable environment such as a plastic bag. Sweat produced by the limb is
trapped in the occlusive bag. The skin can then be blotted with an absorbent material or wiped
with a specially designed absorbent skin wipe. The quantity of sweat collected is estimated by
comparing the precollection and postcollection weights of the blotter or wipe.

Liquid perspiration also can be harvested from the occlusive bag using a calibrated capillary tube.
Nonocclusive LP collection techniques have also used blotters, skin wipes, and capillary tubes.
Sweat is harvested from perspiration that accumulates on the skin. Different absorbent materials
such as gauze and specially formulated materials have been used for these collections. Blotting
and skin wiping have obvious limitations. Physiological materials such as sebum, statium
corneum, and drugs or chemicals deposited on the skin may be collected in addition to the LP.
The blotters and skin wipes may be inconsistent in texture and weight, making collections time-
consuming and problematic. Capillary tube collections also have limitations. The tubes are fragile


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53


Sweat Patch Screen Results (Group A)

CHT Sample # _ COC/BZE Opiates THC PCP AMP/METH
NIST 101 SP neg neg neg neg neg
NIST 105 SP POSITIVE neg neg neg neg
NIST 107 SP neg neg neg neg neg
NIST 111 SP neg neg neg neg neg
NIST 112 SP neg neg neg neg neg
NIST 113 SP POSITIVE neg neg neg neg
NIST 114 SP neg neg neg neg neg
NIST 115 SP neg neg neg neg neg
NIST 116 SP NT NT NT NT NT
NIST 119 SP POSITIVE neg neg neg neg
NIST 120 SP. neg neg neg neg neg
NIST 121 SP. neg neg neg neg neg
NIST 124 SP neg neg neg neg neg
NIST 125 SP POSITIVE POSITIVE neg neg neg
NIST 129 SP neg neg neg neg neg
NIST 130 SP NT NT NT NT NT
NIST 131 SP POSITIVE neg neg neg POSITIVE
NIST 135 SP NT NT NT NT NT
NIST 136 SP neg neg neg neg neg
NIST 138 SP neg POSITIVE neg neg POSITIVE
NIST 139 SP neg neg neg neg neg
NIST 141 SP neg neg neg neg neg
NIST 143 SP POSITIVE neg neg neg neg
NIST 152 SP POSITIVE neg neg neg neg
NIST 155 SP neg neg neg neg neg
NIST 160 SP POSITIVE neg neg neg neg
NIST 163 SP NT NT NT NT NT
NIST 165 SP neg neg neg neg neg
NIST 169 SP neg neg neg neg neg
NIST 171 SP POSITIVE POSITIVE neg neg neg
NIST 175 SP neg neg neg neg neg
NIST 176 SP neg neg neg neg neg
NIST 178 SP neg neg neg neg neg
NIST 183 SP. neg neg neg neg POSITIVE
NIST 186 SP neg neg neg neg POSITIVE
NIST 192 SP POSITIVE POSITIVE neg neg neg
NIST 198 SP neg neg neg neg neg
NIST 199 SP. neg neg neg neg neg
NIST 205 SP POSITIVE neg neg neg neg
NIST 208 SP neg neg neg neg neg
NIST 209 SP POSITIVE neg neg neg neg
NIST 212 SP POSITIVE neg neg neg neg
NIST 214 SP NT NT NT NT NT
NIST 224 SP neg neg neg neg neg
NIST 225 SP. POSITIVE neg neg neg neg
NIST 232 SP neg neg neg neg neg
NIST 233 SP neg neg neg neg neg
NIST 235 SP neg neg neg neg neg

36



obtain their drug screening results for those subjects. However, PSA did not screen all urine
specimens for cannabinoids, PCP, and amphetamines. Therefore, the comparisons made
between urine, SP, and LP test results for group A were based upon urine screening data, MS
confirmed SP, and LP data. Although this should be considered, immunoassay screens have a
high rate of confirmation for most drugs of abuse; the exceptions in urine being opiates and
amphetamines.

Amphetamines screens often have a low rate of confirmation due to reactivity with drugs over-
the-counter such as, cold and diet preparations. However, few amphetamines were detected in
the field study. Opiate screens often have a low rate of confirmation due to immunoassay
reactivity to prescription opioid drugs such as hydromorphone and hydrocodone that are quite
prevalent in the general population. This was not a problem in our study because in arrestee
populations, heroin, 6é—AM, or morphine are the most commonly detected opiates (Crouch, et al.,
2002; and Yacoubian, et al., 2002). Therefore, the U1 and U2 screening results are likely to
reflect illicit opiate use. This is supported by the data that showed that 89 % of screen positive
SP opiates were confirmed by MS, and 100 % of the cases in which urine was available for MS
analysis confirmed positive for opiates.

From the beginning of this research, limitations were identified for the use of LP for drug testing in
the criminal justice system. The price of the current commercial Macroduct exceeds that of patch
testing ($7/sweat collection vs. $5/sweat patch). An initial investment of $1575 is needed for the
power supply. The cost of a collection using the modified collector was $28.56 for materials. This
limits its potential use when compared to the cost of conventional criminal justice system
collections of SP or urinalysis. A second limitation was that the original collection procedure and
device harvested 50 pL to 60 pL of LP in what sometimes approached 30 min. Through the
cooperation of the manufacturer we were able to increase the collection volume to 80 pL to 100 wL
(mean 85.5) in approximately 20 min (mean 24), making LP and LP collection more viable for use
in the criminal justice system. The modified LP collection device appeared to meet an additional
central criteria of an alternative, less invasive method as demonstrated by the subjects rating the
device and its procedures more comfortable, less embarrassing, and less unpleasant than a urine
collection.

5. CONCLUSIONS

Several conclusions can be reached from this research.

¢ Liquid perspiration can be harvested in criminal justice settings using the modified or
standard collector. Minimal training was required for the project staff to use the
collection apparatus effectively, and the device was readily accepted by both agency
staff and arrestees.

e The modified collector can be used in criminal justice settings to collect LP specimens
in a noninvasive, totally observed process, and the procedure was well tolerated by the
subjects. Subjects found the modified collector to be more comfortable, less
embarrassing, and less unpleasant than a urine collection.

24


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41



positive for cocaine while only 12 % of the urine specimens were positive. Our investigation of
this problem led us to conclude that the commercial EIA kit used for the analyses had changed
specificity such that it was no longer suitable for the analysis of LP for cocaine. However, the
same kit was used successfully to screen the SP specimens from group A. Also, recall that of the
10 LP specimens selected for confirmation (from group B), 1/2 contained cocaine or metabolite
by MS. In addition, a 70 % screen positive cocaine rate was found in the pilot study, and a 20 %
positive cocaine rate was recently reported in a similar criminal justice population (Yacoubian,
et al., 2002). Therefore, despite the apparent failure of the EIA cocaine screening, a high
prevalence of cocaine use in the selected population likely accounts for a substantial number of
the positive results.

Liquid perspiration proved to be a superior specimen to urine for the screening of opiates. Each
case that tested positive for opiates in the urine also tested positive in the LP. However, an
additional 19 cases of opiate use were detected by the LP screening.

Conclusions from the cannabinoid and PCP group B screening data should be made cautiously,
because positive cases for these drugs were rare in the urine or LP. However, fewer cannabinoid
positives were found in LP. These results were consistent with the pilot study. EIA testing for
PCP is generally quite specific with high confirmation rates. Therefore, the group B PCP data,
that showed consistency between urine and LP positive rates, are likely indicative of LP being a
useful specimen for the detection of this drug. These data also demonstrate that lipophilic drugs
of abuse (THC and PCP) can be detected in LP. The low prevalence of these drugs in the pilot
study (and in saliva studies) have led some authors to suggest that LP and saliva might not be the
optimum specimens for detection of lipophilic drugs (Crouch, et al., 2002; and Yacoubian, et al.,
2002).

The utility of LP as a screening specimen in the criminal justice system was also demonstrated
by the detection of drugs not detected in urine or SP screening in the random selection if 25
group A subjects (whose U1, U2, and SP specimens screened negative). The EIA detection rates
of opiates, PCP, and cannabinoids in this subpopulation was 10 %, 4 %, and 4 %, respectively,
despite the fact that these drugs were not detected in the corresponding urine or SP specimens.

Study results from group A also demonstrated that LP specimens could be analyzed for the
presence of the major drugs of abuse in a criminal justice setting. The data from group A showed
that when cocaine or metabolites or opiates were detected in U1 or U2, the corresponding LP
specimen contained cocaine; and that cocaine was confirmed by MS in at least twice as many LP
as urine specimens. Similar results were observed with opiates. If U1 or U2 tested positive for
opiates, they were also detected in the LP specimens; and that opiates were confirmed in nearly
twice as many LP specimens. The SP vs. urine results for cocaine and opiates were similar to
those of LP. Cocaine or metabolite and opiates were detected in the SPs at a rate approximately
50 % greater than that of urine. LP specimen analysis by MS exhibited fairly high congruence
with the sweat patch (SP) results (80 % to 84 % agreement rates) for cocaine, but less for the
detection of opiates (44 % agreement rate). The limited use and detection of cannabinoids, PCP,
and amphetamines by the group A subjects was anticipated based on the pilot study.

Due to PSA’s need to process the arrestees for adjudication purposes, subject urine specimens
were sometimes difficult to obtain as explained in the results section. As a result, we arranged to

23


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COMMONLY USED SYMBOLS AND ABBREVIATIONS

ampere hf high frequency o.d. outside diameter

alternating current Hz hertz, Q ohm

amplitude modulation id. inside diameter P- page

candela in inch Pi pascal

centimeter IR infrared Pe probable error

chemically pure J joule pp. pages

cycle per second L lambert Ppt parts per million

day L liter Qt quart

decibel Ib pound Rad radian

direct current Ibf pound-force Rf radio frequency

degree Celsius Ibfin _ pound-force inch Rh relative humidity

degree Fahrenheit Im lumen Ss second

diameter In logarithm (base e) SD standard deviation

electromotive force log logarithm (base 10) sec. section

equation M molar SWR standing wave ratio

farad m meter uhf ultrahigh frequency

footcandle iv micron UV ultraviolet

figure min minute Vv volt

frequency modulation mm millimeter vhf very high frequency

foot mph miles per hour WwW watt

foot per second ms meter per second a wavelength

acceleration mo month wk week

gram N newton wt weight

grain Nm newton meter yr year

henry nm nanometer

hour No. number

area = unit’ (e.g,, ft, in’, etc.); volume = unit’ (e.g,, ft°, m’, etc.)
PREFIXES (See ASTM E380) COMMON CONVERSIONS

deci (10") da deka (10) 0.30480 m= 1 ft 4.448222 N = 1 Ibf
centi (107) h hecto (10°) 25.4 mm= 1 in 1.355818 J= 1 ft-lbf
milli (10°) k kilo (10°) 0.4535924 kg = 1 Ib 0.1129848 N m= 1 Ibftin
micro (10°) M___ mega (10%) 0.06479891g = lgr 14.59390 N/m = I Ibf/ft
nano (10°) G  giga(10°) 0.9463529 L= 1 qt 6894.757 Pa= 1 Ibffin®
pico (10°) T  tera(10") 3600000 J = 1 kW-hr 1.609344 knv/h = 1 mph

Temperature: T e¢ = (T° -32)*5/9

psi = mm of Hg x (1.9339 x 10?)
mm of Hg = psi x 51.71

Temperature: T °p = (T e¢ x9/5)+32


Table 3. Percentage of subjects reporting using/not using drugs

Drug/Drug Category % Not Using | % Using
Marijuana 83% 17%
Cocaine/Crack 75.5 % 24.5 %
Heroin 88% 12%
Hallucinogens 95 % 5%

Table 4. Percentage of subjects reporting using/not using drugs
at session two

Drug/Drug Category | % Not Using | % Using
Marijuana 87% 13%
Cocaine/Crack 83% 17%
Heroin 94% 6%
Hallucinogens 96.5 % 3.5%

The self-report data in these tables are compared to those from analysis of the biological
specimens below.

3.3 Results: Biological Specimens
3.3.1 Group A

Group A subjects attended two sessions and had U1, U2, LP1, and LP2 specimens as well as an
SP collected. Both the urine and the SP specimens were screened for all 5 drug classes, and the
presumptive-positive screening results were confirmed by MS. MS analyses were then performed
on the LP1 and LP2 specimens from all subjects whose urine or SP specimen(s) screened
positive. The detailed tables in the group A appendix show the results of the urine screening (U1,
U2), a summary of the urine specimens that screened positive, the MS confirmation results, and a
list of the samples that were screened positive at PSA. An analogous set of tables in the appendix
shows the detailed results of the SP screening, a summary of the screened-positive specimens and
the MS confirmation results for the specimens that screened positive. Also included is a table
titled “Group A Summary of Urine, Sweat Patch, and LP Results.” This table presents the U1, U2,
and SP screening results and the MS results for the urine, SP, and LP specimens. Recall that 25
group A subjects were randomly selected in which both the urine and SP specimens screened
negative and drug screens were performed on their LP1 and LP2 specimens. Those data are
shown in detail in the appendix table titled “Liquid Perspiration Screen Results Group A
“Negative” Samples” and discussed below.

Eighty-nine (89) subjects were recruited for group A. Table 5 shows a summary of the urine
screening results from CHT and PSA for U1 and U2 for these subjects. The urine, SP, and LP
screen positive rates (%) were calculated based on the total number of screening results available
for each drug.

14


Group B Liquid Perspiration Screen Results

CHT Sample # COC/BZE Opiates PCP THC AMP. METH
NIST 210 LPX neg neg neg neg neg neg
NIST 211LPX = POSITIVE neg neg neg POSITIVE neg
NIST 213 LPX POSITIVE POSITIVE neg neg neg neg
NIST 215 LPX POSITIVE neg neg neg neg neg
NIST 216LPX POSITIVE neg neg neg neg neg
NIST 218LPX POSITIVE neg neg neg neg neg
NIST 219LPX POSITIVE POSITIVE neg neg neg neg
NIST 220LPX = POSITIVE neg neg neg neg neg
NIST 221LPX POSITIVE neg neg neg neg neg
NIST 222 LPX POSITIVE neg neg neg neg neg
NIST 223 LPX neg neg neg neg neg neg
NIST 226LPX = POSITIVE POSITIVE neg neg neg neg
NIST 228 LPX POSITIVE neg neg neg neg neg
NIST 230 LPX = POSITIVE POSITIVE neg neg neg neg
NIST 231LPX = POSITIVE neg neg neg neg neg
NIST 234LPX = POSITIVE neg neg neg neg neg
NIST 236LPX POSITIVE POSITIVE neg neg neg neg
NIST 237LPX POSITIVE neg neg neg neg neg
NIST 238LPX POSITIVE neg neg neg neg neg
NIST 239LPX = POSITIVE neg neg neg neg neg
NIST 240 LPX POSITIVE POSITIVE neg neg neg neg
NIST 243 LPX = POSITIVE POSITIVE neg neg neg neg
NIST 245 LPX neg neg neg neg neg neg
NIST 247LPX = POSITIVE POSITIVE neg neg neg neg
NIST 248LPX = POSITIVE neg neg neg neg neg
NIST 249LPX = POSITIVE neg neg neg neg neg
NIST 250 LPX neg neg neg neg POSITIVE neg
NIST 251LPX POSITIVE neg POSITIVE neg POSITIVE neg
NIST 252LPX = POSITIVE POSITIVE neg neg POSITIVE neg
NIST 253 LPX = POSITIVE POSITIVE neg neg POSITIVE POSITIVE
NIST 254 LPX neg neg neg neg neg neg
NIST 257 LPX neg neg neg neg POSITIVE neg
NIST 259 LPX neg neg neg neg POSITIVE POSITIVE
NIST 260 LPX neg neg neg neg POSITIVE neg
NIST 262LPX = POSITIVE POSITIVE neg neg POSITIVE neg
NIST 263LPX = POSITIVE neg neg neg neg neg
NIST 268LPX POSITIVE neg neg neg neg neg
NIST 270LPX = POSITIVE neg neg neg neg neg
NIST 273 LPX = POSITIVE neg neg neg neg neg
NIST 274 LPX POSITIVE neg neg neg neg neg
NIST 283 LPX neg neg neg neg neg neg
NIST 286LPX = POSITIVE neg neg neg neg neg
NIST 287 LPX neg neg neg neg neg neg
NIST 288LPX POSITIVE neg neg neg neg POSITIVE
NIST 289LPX POSITIVE neg neg neg neg neg
NIST 292 LPX POSITIVE POSITIVE neg neg neg neg
NIST 295LPX POSITIVE neg neg neg neg neg
NIST 302 LPX neg neg POSITIVE neg neg neg
NIST 303LPX = POSITIVE neg neg neg neg neg
NIST 304LPX = POSITIVE POSITIVE neg neg neg neg
NIST 305 LPX POSITIVE neg neg neg neg neg
NIST 311 LPX neg POSITIVE neg neg neg neg
NIST 313LPX POSITIVE neg neg neg neg neg
NIST 324LPX POSITIVE neg neg neg neg neg
NIST 325LPX POSITIVE POSITIVE neg neg neg neg
NIST 326 LPX POSITIVE neg neg neg neg neg
NIST 327 LPX POSITIVE POSITIVE neg neg neg neg

n=115

51



Group A Urine Drug Screen Results

CHT Sample # COC/BZE Opiates THC-COOH PCP AMP/METH
NIST 176 U2 neg neg neg neg neg
NIST 178 U1 neg neg neg neg neg
NIST 178 U2 neg neg neg neg neg
NIST 183 U1 neg neg neg neg neg
NIST 186 U1 neg neg neg neg neg
NIST 192 U1 neg neg neg neg neg
NIST 198 U1 neg neg neg neg neg
NIST 198 U2 neg neg neg neg neg
NIST 205 U1 neg neg neg neg neg
NIST 208 U2 neg neg neg neg neg
NIST 209 U1 neg neg neg neg neg
NIST 212 U2 neg neg neg neg neg
NIST 224 U1 neg neg neg neg neg
NIST 225 U1 neg neg neg neg neg
NIST 232 U1 neg neg neg neg neg
NIST 232 U2 neg neg neg neg neg
NIST 233 U1 neg neg POSITIVE neg neg
NIST 233 U2 neg neg POSITIVE neg neg
NIST 235 U1 neg neg neg neg neg
NIST 235 U2 neg neg neg neg neg
NIST 241 U1 neg neg neg neg neg
NIST 242 U1 POSITIVE neg POSITIVE neg neg
NIST 242 U2 POSITIVE neg POSITIVE neg neg
NIST 246 U1 neg neg neg neg neg
NIST 246 U2 neg neg neg neg neg
NIST 255 U2 POSITIVE POSITIVE neg neg neg
NIST 256 U2 neg neg neg neg neg
NIST 261 U1 neg neg neg neg neg
NIST 261 U2 neg neg neg neg neg
NIST 264 U1 neg neg neg neg neg
NIST 265 U1 neg neg neg neg neg
NIST 266 U1 neg neg neg neg neg
NIST 269 U1 neg neg neg neg neg
NIST 275 U1 neg neg neg neg neg
NIST 275 U2 neg neg neg neg neg
NIST 277 U1 neg neg neg neg neg
NIST 277 U2 neg neg neg neg neg
NIST 278 U1 neg neg neg neg neg
NIST 278 U2 neg neg neg neg neg
NIST 280 U1 neg neg neg neg neg
NIST 280 U2 neg neg neg neg neg
NIST 281 U1 neg neg neg neg neg
NIST 281 U2 neg neg neg neg neg
NIST 282 U1 neg neg neg neg neg
NIST 282 U2 POSITIVE neg neg neg neg
NIST 284 U1 neg neg neg neg neg
NIST 284 U2 neg neg neg neg neg
NIST 285 U1 neg neg neg neg neg
NIST 285 U2 neg neg POSITIVE neg neg

31



Group A Urine Drug Screen Results

CHT Sample # COC/BZE Opiates THC-COOH PCP. AMP/METH
NIST 293 U4 neg neg neg neg neg
NIST 294 U1 neg neg neg neg neg
NIST 294 U2 neg POSITIVE neg neg neg
NIST 296 U1 neg POSITIVE POSITIVE neg neg
NIST 299 U1 neg neg neg neg neg
NIST 299 U2 neg neg neg neg neg
NIST 300 U1 neg neg neg neg neg
NIST 300 U2 POSITIVE neg neg neg neg
NIST 301 U2 neg neg neg neg neg
NIST 307 U1 POSITIVE neg neg neg neg
NIST 309 U1 neg neg neg neg neg
NIST 309 U2 neg neg neg neg neg
NIST 312 U2 POSITIVE POSITIVE neg neg neg
NIST 314 U1 neg neg neg neg neg
NIST 314 U2 neg neg neg neg neg
NIST 315 U1 neg neg neg neg neg
NIST 315 U2 neg neg neg neg neg
NIST 319 U1 neg neg neg neg neg
NIST 320 U2 neg neg neg neg neg
NIST 321 U1 neg neg neg neg neg
NIST 321 U2 neg neg neg neg neg
NIST 322 U1 neg neg neg neg neg
NIST 322 U2 neg neg neg neg neg
NIST 323 U1 neg neg neg neg neg
NIST 323 U2 neg neg neg neg neg

n=125

32



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cocaine, opiates, and amphetamines, drugs were detected in the LP when they were not detected
in the subject’s urine as evidenced by the urine negative/LP positive category of results.

Table 11. Group B liquid perspiration screen results vs. urine screen results

Cocaine Opiates _Cannabinoids _Phencyclidine Amphetamine
Positive Urine
Screens n=13 n=8 n=6 n=4 n=1
Urine Positive/ 13 8 0 4 0
LP Positive 100 % 100 % 0% 100 % 0%
Urine Positive/ 0 0 6 0 1
LP Negative 0% 0% 100% 0% 100 %
Negative Urine
Screens n=73 n=77 n=79 n=80 n=81
Urine Negative/ 12 65 79 80 69
LP Negative 16% 84% 100 % 100 % 85 %
Urine Negative/ 61 12 0 0 12
LP Positive 84% 16% 0% 0% 15%

As mentioned above, the EIA test for cocaine performed poorly and nearly all of the group B

LP specimens screened positive. Therefore, we selected 10 specimens for confirmation. The
specimens were randomly selected from those that screened positive and had an adequate volume
for confirmation testing. Cocaine or BZE was detected in 5 of the 10 specimens analyzed by MS.

3.4 Comparison of Results from Self-Reports and Biological Specimens

It was of interest to compare the results of the biological specimen analysis—especially the LP
analysis—with the self-reports. The following tables provide comparisons of self-reports (use of
any drug in the past 30 days: yes/no) with the results of the analysis of the biological specimens
(positive/negative).

Table 12 compares self-reports with urine screens. First session subjects displayed a 70 %
agreement rate (70 % of the time, subjects’ self-reports agreed with their urine screen results); in
the second session, the agreement rate was 88 %. (A 100 % agreement rate would not be expected
even if all subjects were truthful and accurate, as the subjects are self-reporting in reference to a
time span (30 days) that is beyond the detection range of the biological specimen analysis).
Interestingly, in the first session, there were 43 subjects (27 % of the sample) who admitted some
kind of illicit drug use, but were found negative by urine screening.

20


Group B Liquid Perspiration Screen Results

CHT Sample # COC/BZE Opiates PCP. THC AMP. METH
NIST 102LPX = POSITIVE neg neg neg neg neg
NIST 108LPX POSITIVE POSITIVE POSITIVE neg neg neg
NIST 109LPX POSITIVE neg neg neg neg neg
NIST 110 LPX = POSITIVE POSITIVE neg neg neg neg
NIST 117 LPX. POSITIVE POSITIVE neg neg neg neg
NIST 118LPX POSITIVE neg neg neg neg neg
NIST 122 LPX POSITIVE POSITIVE neg neg neg neg
NIST 123 LPX POSITIVE neg neg neg neg neg
NIST 126LPX POSITIVE neg neg neg neg neg
NIST 127 LPX POSITIVE neg neg neg neg neg
NIST 132 LPX POSITIVE neg neg neg neg neg
NIST 133 LPX = POSITIVE neg neg neg neg neg
NIST 134 LPX POSITIVE neg neg neg neg neg
NIST 137 LPX = POSITIVE neg neg neg neg neg
NIST 140 LPX = POSITIVE neg neg neg neg neg
NIST 142LPX = POSITIVE neg neg neg neg neg
NIST 144LPX = POSITIVE neg neg neg neg neg
NIST 145LPX POSITIVE neg neg neg neg neg
NIST 146 LPX POSITIVE POSITIVE neg neg neg neg
NIST 147LPX = POSITIVE neg neg neg neg neg
NIST 148 LPX POSITIVE neg neg neg neg neg
NIST 149LPX POSITIVE neg POSITIVE neg neg neg
NIST 150 LPX POSITIVE neg neg neg neg neg
NIST 151 LPX POSITIVE neg neg neg neg POSITIVE
NIST 153 LPX POSITIVE neg neg neg neg neg
NIST 154LPX = POSITIVE POSITIVE neg neg neg neg
NIST 156LPX POSITIVE neg neg neg neg neg
NIST 157 LPX neg neg neg neg neg neg
NIST 158LPX POSITIVE neg neg neg neg neg
NIST 159LPX POSITIVE neg neg neg neg POSITIVE
NIST 161LPX POSITIVE POSITIVE neg neg neg neg
NIST 164 LPX POSITIVE neg neg neg neg neg
NIST 166LPX POSITIVE neg neg neg neg neg
NIST 167LPX = POSITIVE neg neg neg neg neg
NIST 168 LPX neg neg neg neg neg neg
NIST 172 LPX POSITIVE neg neg neg neg neg
NIST 173LPX POSITIVE neg neg neg neg neg
NIST 177LPX POSITIVE neg neg neg neg neg
NIST 179 LPX POSITIVE neg neg neg neg neg
NIST 180 LPX POSITIVE neg neg neg neg neg
NIST 182LPX POSITIVE POSITIVE neg neg neg neg
NIST 185 LPX POSITIVE neg neg neg neg neg
NIST 187 LPX POSITIVE neg neg neg neg neg
NIST 188 LPX POSITIVE neg neg neg neg neg
NIST 189LPX POSITIVE neg neg neg neg neg
NIST 190 LPX POSITIVE neg neg neg neg neg
NIST 191LPX POSITIVE POSITIVE neg neg neg POSITIVE
NIST 193LPX POSITIVE neg neg neg neg neg
NIST 194LPX POSITIVE neg neg neg POSITIVE neg
NIST 195LPX POSITIVE POSITIVE neg neg neg neg
NIST 196 LPX POSITIVE POSITIVE neg neg neg neg
NIST 197LPX = POSITIVE neg neg neg POSITIVE neg
NIST 200 LPX = POSITIVE neg neg neg neg neg
NIST 201 LPX POSITIVE neg neg neg neg neg
NIST 202 LPX POSITIVE neg neg neg neg neg
NIST 203LPX = POSITIVE neg neg neg neg neg
NIST 206LPX = POSITIVE neg neg neg neg neg
NIST 207 LPX___ POSITIVE neg neg neg neg POSITIVE

50



ACKNOWLEDGMENTS

The technical effort to develop this report was conducted under Interagency Agreement 94—IJ-R-004, Project No.
03-002.

This report was prepared for the National Institute of Justice, U.S. Department of Justice, by the Office of Law
Enforcement Standards (OLES) of the National Institute of Standards and Technology (NIST).

This report was conducted under the direction of Alim A. Fatah, Program Manager for Chemical Systems and
Materials, and Kathleen M. Higgins, Director of OLES.


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39



Sweat Patch Screen Results (Group A)

CHT Sample # — COC/BZE Opiates THC PCP AMP/METH
NIST 241 SP neg neg neg neg neg
NIST 242 SP POSITIVE neg neg neg POSITIVE
NIST 246 SP neg neg neg neg neg
NIST 255 SP POSITIVE POSITIVE neg neg neg
NIST 256 SP neg neg neg neg neg
NIST 261 SP POSITIVE neg neg neg neg
NIST 264 SP POSITIVE POSITIVE neg neg POSITIVE
NIST 265 SP neg neg neg neg neg
NIST 267 SP POSITIVE POSITIVE neg neg neg
NIST 269 SP neg POSITIVE neg neg neg
NIST 275 SP neg POSITIVE neg neg neg
NIST 276 SP neg neg neg neg neg
NIST 277 SP neg neg neg neg neg
NIST 278 SP neg neg neg neg neg
NIST 279 SP neg neg POSITIVE POSITIVE neg
NIST 280 SP POSITIVE neg neg neg neg
NIST 281 SP neg neg neg neg neg
NIST 282 SP POSITIVE neg POSITIVE neg neg
NIST 284 SP POSITIVE POSITIVE neg neg neg
NIST 285 SP neg neg neg neg neg
NIST 291 SP POSITIVE neg neg neg neg
NIST 293 SP POSITIVE neg neg neg neg
NIST 294 SP neg POSITIVE neg neg neg
NIST 296 SP POSITIVE POSITIVE neg neg neg
NIST 297 SP neg neg neg neg neg
NIST 298 SP POSITIVE POSITIVE neg neg neg
NIST 299 SP neg neg neg neg neg
NIST 300 SP POSITIVE neg neg neg neg
NIST 301 SP neg neg neg neg neg
NIST 306 SP neg POSITIVE neg neg neg
NIST 307 SP POSITIVE POSITIVE neg neg neg
NIST 308 SP neg POSITIVE neg neg neg
NIST 309 SP POSITIVE POSITIVE neg neg neg
NIST 310 SP neg neg neg neg neg
NIST 312 SP POSITIVE POSITIVE neg neg neg
NIST 314 SP neg neg neg neg neg
NIST 315 SP neg neg neg neg neg
NIST 319 SP neg neg neg neg neg
NIST 320 SP neg neg neg neg neg
NIST 321 SP neg neg neg neg neg
NIST 322 SP neg neg neg neg neg
NIST 323 SP POSITIVE neg neg neg neg

n=83

37



Table 2. Summary of LP confirmation methods

Analytes Cocaine* PCP THC/COOH | Amphetamines** | Opiates***

Method | LC/MS/MS _| LC/MS/MS _| GC/MS LC/MS/MS LC/MS/MS

Extraction | Solid Phase | Solid Phase | Solid Phase | Liquid/Liquid Solid Phase

Calibrators] 0, .5, 1, 5, 10, | 0, .25,.5, 1, | 0,1, 2,4, 10, | 0., 20, 50 100, 0, 1, 5, 10, 25,
(mg/mL) | 25, 50,100, | 5, 10, 25, 50,) 25, 100, 150, | 250, 500, and 50, 200, 250,

125, and 150 | and 100 200, and 250 | 1000 and 500
Internal
Stand D3 DS D3 DS5/D8 DS
Amount
(ng) 50 5 10 100 50

* Cocaine, benzoylecgonine, and ecgonine methy] ester.

** Amphetamine, methamphetamine, phentermine and over-the-counter sympathomimetic
amines.

*** Morphine, codeine, 6-acetylmorphine, and heroin.

Drug test results from the pilot urine, sweat patch, and LP specimens showed that 12 urine
specimens tested negative when drugs were detected in the corresponding LP specimens. One
sweat patch tested negative when the urine or LP specimens tested positive. Only two LP
specimens tested negative when the sweat patch was positive.

1.5.4 Conclusions

Several conclusions were reached from the study. LP could be harvested in criminal justice
settings. The collection of LP was considered noninvasive, it could be totally observed, and the
procedure was well tolerated by the subjects. Subjects found the Macroduct collection no more
unpleasant and significantly less embarrassing than a urine collection. Drugs of abuse and their
metabolites were excreted in LP. This was suggested by the research that has been reported using
the sweat patch, but had not actually been demonstrated until this study was performed.

The volume of LP collected was a limitation. A typical collection was 40 pL to 80 wL. This
volume was sufficient to either screen for the drugs of abuse, or to perform a limited screen and
confirm no more than one or two drugs. However, LP may be a preferable specimen to urine for
the detection of drug use because it appeared to be a good to excellent sample for the detection of
opiates and cocaine; and it was consistent with urine and outperformed the sweat patch for the
detection of PCP. However, it was outperformed by the urine and the sweat patch for the
detection of cannabinoids. Further study of the collection and analysis of LP was needed to fully
understand the advantages and limitations of the specimen. This was particularly true because no
volunteers tested positive for amphetamine(s), only one tested positive for cannabinoids, and one
tested positive for PCP.


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49


2.4 Data Collection Procedures

Data were collected onsite at two PSA offices that served several hundred clients daily. Data
collection occurred during regular office hours over a six-month period, beginning in April 2001
and ending in September 2001. All arrestees who were required to report to the two offices for
drug testing were eligible to participate in the project, and a $20 cash stipend was provided at the
end of each session. Participants were recruited mainly through flyers posted in the offices; a few
participants were recruited face-to-face by the analyst.

A total of 204 arrestees participated in the study. There were 89 two-session subjects (group A)
and 115 one-session subjects (group B). When a subject volunteered, he or she was randomly
assigned as a group A or group B participant. The analyst explained the study and its basic
procedures, and a written informed consent was obtained from each participant. The informed
consent advised participants that their questionnaire responses and drug test results would be
confidential and the test results would not be used against them in any legal proceeding.
Additionally, researchers and agency staff emphasized that the test results would not affect
participant involvement in their pretrial obligations.

For group A, the two sessions of data collection were approximately one week apart. During
session one, each participant provided a urine and an LP specimen, and a sweat patch was
applied. While the LP specimen was collected (which required 20 min to 30 min), the drug survey
was administered. During session two, the sweat patch was harvested, the subject was provided a
second LP and urine specimen, and the subject completed a second drug survey.

Group B subjects had a single session. The participants provided a urine and an LP specimen, and
completed a drug survey.

LP collection began with an introduction to the equipment and procedures and an opportunity for
participants to have their questions and concerns addressed. Then the electrodes with the gel-disks
containing pilocarpine were attached to the participant's lower arm. The inducer was activated and
a low-level current established for approximately 2 min to 3 min. After induction, the modified
(larger) LP collector was placed over the area where the induction had occurred and it was
secured to the subject’s arm with a Velcro strap. The LP was collected into the spiral-capillary
holding tube portion of the collector. Throughout the process, the research assistant adhered
strictly to the manufacturer's instructions for collection. At the conclusion of the LP collection,
both the volume collected and the duration of the collection were recorded. The specimens were
then transferred via a blunt-needle syringe into glass storage vials, and the vials were labeled with
unique study identification numbers. The collection site was cleansed using the manufacturer’s
recommended procedures to ensure against specimen contamination.

If the participant was assigned to group A, a sweat patch was applied to the lower ribcage or
upper arm of each participant. Participants were asked to leave the patch in place for one week
and were given instructions for care. Again, the manufacturer’s instructions were followed
explicitly.

After specimen collection and sweat patch application, participants completed a brief survey
about their recent drug use and their perceptions of the collection procedures. This survey asked
participants to rate the LP and urinalysis collection procedures on four dimensions: discomfort,


NISTIR 7140

An Evaluation of Innovative Sweat-Based
Drug Testing Techniques for Use in
Criminal Justice Drug Testing —

Final Report

Dr. Alim A. Fatah*

Royer F. Cook

David C. Dove

Institute for Social Analysis
Alexandria, VA 22314

Dennis J. Crouch

Jakub Baudys

University of Utah

Center for Human Toxicology
Salt Lake City, UT 84112-9457

Coordination by
U.S. DEPARTMENT OF COMMERCE
*Office of Law Enforcement Standards
National Institute of Standards

and Technology
Gaithersburg, MD 20899-8102

July 2004

gent or Cm,

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U.S. DEPARTMENT OF COMMERCE
Donald L. Evans, Secretary

TECHNOLOGY ADMINISTRATION
Phillip J. Bond, Under Secretary for Technology

NATIONAL INSTITUTE OF STANDARDS
AND TECHNOLOGY
Arden L. Bement, Jr., Director


Group A Urine Drug Screen Results

CHT Sample # COC/BZE Opiates THC-COOH PCP AMP/METH
NIST 101 U1 neg neg neg neg neg
NIST 105 U1 neg neg neg neg neg
NIST 105 U2 neg neg neg neg neg
NIST 107 U1 neg neg neg neg neg
NIST 107 U2 neg neg neg neg neg
NIST 111 U1 neg neg neg neg neg
NIST 111 U2 neg neg neg neg neg
NIST 112 U1 neg neg neg neg neg
NIST 112 U2 neg neg neg neg neg
NIST 113 U1 POSITIVE neg neg neg neg
NIST 113 U2 POSITIVE neg neg neg neg
NIST 114 U1 neg neg neg neg neg
NIST 114 U2 neg neg neg neg neg
NIST 115 U1 neg neg neg neg neg
NIST 115 U2 neg neg neg neg neg
NIST 116 U1 neg neg neg neg neg
NIST 116 U2 neg neg neg neg neg
NIST 119 U2 POSITIVE neg neg neg neg
NIST 120 U1 neg neg neg neg neg
NIST 120 U2 neg neg neg neg neg
NIST 121 U1 neg neg neg neg neg
NIST 121 U2 neg neg neg neg neg
NIST 124 U1 neg neg neg neg neg
NIST 125 U1 POSITIVE POSITIVE POSITIVE neg neg
NIST 125 U2 neg neg neg neg neg
NIST 129 U1 neg neg neg neg neg
NIST 129 U2 neg neg neg neg neg
NIST 130 U1 neg neg neg neg neg
NIST 130 U2 neg neg neg neg neg
NIST 131 U1 neg neg neg neg neg
NIST 131 U2 neg neg neg neg neg
NIST 136 U1 neg neg POSITIVE POSITIVE neg
NIST 136 U2 neg neg POSITIVE POSITIVE neg
NIST 138 U1 neg POSITIVE neg neg neg
NIST 139 U1 neg neg neg neg neg
NIST 141 U1 neg neg neg neg neg
NIST 141 U2 neg neg neg neg neg
NIST 143 U1 neg neg neg neg neg
NIST 152 U1 neg neg neg neg neg
NIST 155 U1 neg neg neg neg neg
NIST 155 U2 neg neg neg neg neg
NIST 165 U1 neg neg neg neg neg
NIST 165 U2 neg neg neg neg neg
NIST 169 U1 neg neg neg neg neg
NIST 169 U2 neg neg neg neg neg
NIST 171 U1 neg neg neg neg neg
NIST 175 U1 neg neg neg neg neg
NIST 175 U2 neg neg neg neg neg
NIST 176 U1 neg neg neg neg neg

30



As stated in the methods section, LP specimens were selected for screening from 25 group A
subjects whose U1, U2, and SP specimens tested negative. The purpose of this screening was to
determine if drugs could be found in LP when they were not detected in the urine or SP. The

samples were screened using the validated EIA methods and the project’s LP cutoff

concentrations. As shown in the summary table (9) below, unfortunately, 94 % of the LP
specimens were positive for cocaine due to the failure of the EIA assay (discussed below). In
total, eight specimens screened positive for opiates in the LP that were not positive by urinalysis
10 %). Two LP specimens screened positive for PCP and THC that were urinalysis negative
(4%). No additional amphetamine positive cases were detected through the LP screening. Data in
the table represent potential (because the screening results were not confirmed by MS) false
negative results if one were relying on SP or urine screening results.

Table 9. Group A liquid perspiration screen results for a sample of cases with

negative urine screens
Cocaine Opiates Cannabinoids Phencyclidine Amphetamine

First Session n=25 n=25 n=25 n=25 n=25
Urine Negative/ 1 20 23 24 25
LP Screen negative 4% 80% 92% 96 % 100 %
Urine Negative/ 24 5 2 1 0
LP Screen Positive 96 % 20 % 8% 4% 0%
Second Session n=25 n=25 n=25 n=25 n=25
Urine Negative/ 2 22 25 24 25
LP Screen Negative 8% 88 % 100 % 96 % 100 %
Urine Negative/ 23 3 0 1 0
LP Screen Positive 92% 12% 0% 4% 0%

3.3.2 Group B

Group B subjects attended one session and had one urine and one LP specimen collected. Both
the urine and the LP specimens from these subjects were screened for all drugs. No confirmation
analyses were performed. However, 10 of the LP specimens that screened positive for cocaine
were randomly selected for confirmation testing. The detailed tables in the group B appendix
present the results of the urine screening (UX), a summary of the urine specimens that screened
positive, the MS confirmation results and a list of the samples that were tested at PSA. Analogous
tables present the detailed results of the LP (LPX) screening, a summary of the screened-positive
specimens and the MS confirmation results for the selected specimens that screened positive for

cocaine and were analyzed by MS.

One hundred and fifteen (115) subjects were recruited into group B. Table 10 shows the
combined urine screening results from CHT and the PSA. For each drug, the table also indicates
the number of specimens for which screening data were not available. The number varies between
drug classes because PSA did not test every specimen for cannabinoids, PCP, and amphetamines.
The urine screen positive rates (%) were calculated based on the total number of results available

18



ABOUT THE LAW ENFORCEMENT AND CORRECTIONS
STANDARDS AND TESTING PROGRAM

The Law Enforcement and Corrections Standards and Testing Program is sponsored by the Office of Science
and Technology of the National Institute of Justice (NIJ), U.S. Department of Justice. The program responds to the
mandate of the Justice System Improvement Act of 1979, which created NIJ and directed it to encourage research
and development to improve the criminal justice system and to disseminate the results to Federal, State, and local
agencies.

The Law Enforcement and Corrections Standards and Testing Program is an applied research effort that
determines the technological needs of justice system agencies, sets minimum performance standards for specific
devices, tests commercially available equipment against those standards, and disseminates the standards and the test
results to criminal justice agencies nationally and internationally.

The program operates through:

The Law Enforcement and Corrections Technology Advisory Council (LECTAC) consisting of nationally
recognized criminal justice practitioners from Federal, State, and local agencies, which assesses technological needs
and sets priorities for research programs and items to be evaluated and tested.

The Office of Law Enforcement Standards (OLES) at the National Institute of Standards and Technology, which
develops voluntary national performance standards for compliance testing to ensure that individual items of equipment
are suitable for use by criminal justice agencies. The standards are based upon laboratory testing and evaluation of
representative samples of each item of equipment to determine the key attributes, develop test methods, and establish
minimum performance requirements for each essential attribute. In addition to the highly technical standards, OLES
also produces technical reports and user guidelines that explain in nontechnical terms the capabilities of available
equipment.

The National Law Enforcement and Corrections Technology Center (NLECTC), operated by a grantee, which
supervises a national compliance testing program conducted by independent laboratories. The standards developed by
OLES serve as performance benchmarks against which commercial equipment is measured. The facilities, personnel,
and testing capabilities of the independent laboratories are evaluated by OLES prior to testing each item of equipment,
and OLES helps the NLECTC staff review and analyze data. Test results are published in Equipment Performance
Reports designed to help justice system procurement officials make informed purchasing decisions.

Publications are available at no charge through the National Law Enforcement and Corrections Technology
Center. Some documents are also available online through the Internet/World Wide Web. To request a document or
additional information, call 800-248-2742 or 301-519-5060, or write:

National Law Enforcement and Corrections Technology Center
P.O. Box 1160

Rockville, MD 20849-1160

E-Mail: asknlectc@nlectc.org

World Wide Web address: http:/www.nlectc.org

This document is not intended to create, does not create, and may not be relied upon to create any rights, substantive or
procedural, enforceable at law by any party in any matter civil or criminal.

Opinions or points of view expressed in this document represent a consensus of the authors and do not represent the
official position or policies of the U.S. Department of Justice. The products and manufacturers discussed in this
document are presented for informational purposes only and do not constitute product approval or endorsement by the
USS. Department of Justice.

The National Institute of Justice is a component of the Office of Justice Programs, which also includes the Bureau of Justice
Assistance, the Bureau of Justice Statistics, the Office of Juvenile Justice and Delinquency Prevention, and the Office for Victims of
Crime.



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42


6. REFERENCES

J. Baer and J. Booher, “The Patch: An Alternative for Drug Testing in the Criminal Justice
System.” Federal Probations, 58, 29 (1994).

M. Burns and R. Baselt, “Monitoring drug use with a sweat patch: an experiment with cocaine.
J. Anal. Toxicol., 19, 41 (1995).

E.P. Carter, A.D. Barrett, A.F. Heeley, and J.A. Kuzemko. Improved Sweat Testing Method for
the Diagnosis of Cystic Fibrosis. Archives of Disease Childhood (ADC), 59, 919-922
(1984).

R.F. Cook, A.D. Bernstein, T.L. Arrington, C.M. Andrews, and G.A. Marshall, “Methods for
Assessing Drug Use Prevalence in the Workplace: A Comparison of Self-Report,
Urinalysis and Hair Analysis.” The Intl. J. of the Addictions, 30(4), 403-426, (1995).

D.J. Crouch, R.F. Cook, J.V. Trudeau, D.C. Dove, J.J. Robinson, H.L. Webster, and A.A. Fatah,
“The Detection of Drugs of Abuse in Liquid Perspiration.” J. Anal. Toxicol., 259, 7
(2001).

D.J. Crouch, R.F. Cook, J.V. Trudeau, and D.C. Dove, “An Evaluation of Innovative Sweat-
Based Drug Testing Techniques for Use in Criminal Justice Drug Testing, NISTIR 6825.” .
National Institute of Standards and Technology, Gaithersburg, MD, March 2002.

R. Dembo, L. Williams, E.D. Wish, and J. Schmeidler, “Urine Testing of Detained Juveniles to
Identify High-Risk Youth.” NIJ Research in Brief, Washington, DC: U.S. Department of
Justice (1990).

Department of Health and Human Services, “Mandatory Guideline for Federal Workplace Testing
Programs.” Federal Register, 58 (14), 6062-72 (1993).

J. Fay, R. Fogerson, D. Schoendorfer, S. Niedbala, and V. Spiehler, “Detection of
Methamphetamine in Sweat by EIA and GC-MS.” J. Anal. Toxicol., 29, 398 (1996).

R. Fogerson, D. Schoendorfer, J. Fay, and V. Spiehler, “Qualitative Detection of Opiates in Sweat
by EIA and GC-MS.” J. Anal. Tox., 21, 451-458, October 1997.

J.S. Goldkemp and D. Weiland, “Assessing the Impact of Dade County’s Felony Drug Court.”
NIJ Research in Brief, Washington, DC: U.S. Department of Justice (1993).

K. Hammond, N. Turcios, and L. Givson, “Clinical Evaluation of the Macroduct Sweat
Collection System and Conductivity Analyzer in the Diagnosis of Cystic Fibrosis.” J.
Pediatrics, 124, 255 (1994).

D.A. Kidwell, J.C. Holland, and S. Athanaselis, “Testing for Drugs of Abuse in Saliva and
Sweat.” J. Chromatography, pp. 111-1135 (1998).

26


35

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Table 12. Comparison of self-report and urine specimens

First (or only) Session

Positive Negative
Self-reported Yes 29 43
30 duse No 4 81
Second Session
Positive Negative
Self-reported Yes 12 4
30d use No 3 40

Table 13 compares self-reports with LP results. First session subjects displayed a 43 % agreement
rate (43 % of the time, subjects’ self-reports agreed with their LP results); in the second session,
the agreement rate was 36 %. Again a 100 % agreement rate would not be expected even if all
subjects were truthful and accurate, as the subjects are self-reporting in reference to a time span of
30 d that is well beyond the detection range of the LP drug detection time.

Table 13. Comparison of self-report and liquid perspiration specimens

First (or only) Session

Positive Negative
Self-reported Yes 7 15
30 d use No 89 9
Second Session
Positive Negative
Self-reported Yes 16 6
30 d use No 36 8

Note: LP specimen data are screened or MS confirmation data for those
who tested positive for at least one drug (in a urine screen) and for a
random sub sample of 25 subjects who did not test positive for any drug
(in a urine screen).

The following table (14) compares self-reports with SP results. Recall that SP specimens were
only collected at session two. Subjects displayed a 71 % agreement rate between detected and
admitted use. A higher agreement was expected with the SP results (than the LP) because of the
constant monitoring and specimen collection provided by the SP.

21


sample. The drug content in liquid samples can be quantified such that drug test results can be
reported in concentration/microliter of LP, improving the potential for meaningful interpretation.
Due to the compactness of the Macroduct, mobile collections are feasible, and no special facilities
are needed in the entire collection process. A significant potential advantage over the sweat patch
is that liquid samples could potentially be analyzed at the site of collection by laboratory-based
immunoassay tests or by on-site test kits.

However, there are also disadvantages to the current version of the collection device. The price
currently exceeds that of patch testing ($7/sweat collection vs. $5/sweat patch). An initial
investment of $1575 is needed for the power supply. A second disadvantage is that collection of
50 pL to 60 pL of LP may take 10 min to 15 min. However, this collection time is not that much
in excess of the time required for a urine collection. An additional disadvantage is that the device
is designed for micro-collection, and the volume of LP collected may limit the type and number
of analyses that can be performed. These potential disadvantages were addressed in this project.

1.5 Pilot Study
1.5.1 Introduction

The first phase of the research was a pilot study designed to gather data on criminal justice system
subjects’ perceptions about the use of the Macroduct, to develop drug testing methods for LP, and
to compare drug test results from urine, the sweat patch, and LP.

1.5.2 Methodology

Subjects were recruited and specimens collected onsite at the pretrial agency’s satellite office that
serves several hundred clients daily. Data collection occurred during regular office hours over a 3-
week period in early 2000 (Crouch, et al., 2001; and Crouch, et al., 2002). All arrestees who were
required to report to the satellite site for drug testing were eligible to participate in the project, and
a $20 cash stipend was provided at the end of each session. Thirty-two arrestees participated in
the pilot study. Written informed consent was obtained from each participant, and researchers
emphasized that the drug test results would not be used in the participant’s legal proceeding.

The pilot study involved two sessions of data collection that were one week apart. During session
one, a sweat patch was applied to each participant, and he or she provided a urine and a LP
specimen. After specimen collection and sweat patch application, participants completed a brief
questionnaire about their recent drug use and their perceptions of the collection procedures.
Participants were scheduled to return approximately one week later for session two during which
the sweat patch was harvested, and he or she provided a second urine and an LP specimen, and
completed a second questionnaire.

1.5.3 Results

Volunteers rated the urine, sweat patch, and liquid perspiration collections on four dimensions:
1) discomfort, 2) lengthiness of collection, 3) unpleasant sensations, and 4) embarrassment.
Analysis of variance revealed that the discomfort ratings for the liquid perspiration and urine
collections did not demonstrably differ. Likewise, differences in ratings of lengthiness of the


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43


Group B Urine Drug Screen Results

CHT Sample # COC/BZE Opiates THC-COOH PCP AMP/METH
NIST 102 UX neg neg neg neg neg
NIST 108 UX neg POSITIVE neg POSITIVE neg
NIST 109 UX neg neg neg neg neg
NIST 110 UX POSITIVE POSITIVE neg neg POSITIVE
NIST 117 UX neg POSITIVE neg neg neg
NIST 118 UX neg neg neg neg neg
NIST 122 UX neg POSITIVE neg neg neg
NIST 126 UX POSITIVE neg neg neg neg
NIST 127 UX neg neg neg neg neg
NIST 132 UX neg neg neg neg neg
NIST 133 UX neg neg neg neg neg
NIST 137 UX neg neg neg neg neg
NIST 140 UX neg neg neg neg neg
NIST 142 UX neg neg neg neg neg
NIST 145 UX neg neg neg neg neg
NIST 146 UX neg neg neg neg neg
NIST 147 UX neg neg neg neg neg
NIST 148 UX neg neg neg neg neg
NIST 149 UX neg neg POSITIVE POSITIVE neg
NIST 150 UX neg neg neg neg neg
NIST 151 UX neg neg neg neg neg
NIST 153 UX neg neg neg neg neg
NIST 154 UX neg neg neg neg neg
NIST 157 UX neg neg neg neg neg
NIST 161 UX neg neg neg neg neg
NIST 164 UX neg neg neg neg neg
NIST 166 UX neg neg neg neg neg
NIST 168 UX neg neg neg neg neg
NIST 173 UX POSITIVE neg POSITIVE neg neg
NIST 177 UX POSITIVE neg neg neg neg
NIST 179 UX neg neg neg neg neg
NIST 182 UX neg neg neg neg neg
NIST 185 UX neg neg neg neg neg
NIST 187 UX POSITIVE neg neg neg neg
NIST 188 UX neg neg neg neg neg
NIST 189 UX neg neg neg neg neg
NIST 190 UX neg neg neg neg neg
NIST 191 UX neg neg neg neg neg
NIST 193 UX POSITIVE neg neg neg neg
NIST 194 UX neg neg neg neg neg
NIST 196 UX neg neg POSITIVE neg neg
NIST 206 UX POSITIVE neg neg neg neg
NIST 220 UX neg neg neg neg neg
NIST 221 UX neg neg neg neg neg
NIST 222 UX neg neg neg neg neg
NIST 223 UX neg neg neg neg neg
NIST 231 UX neg neg neg neg neg
NIST 234 UX POSITIVE neg neg neg neg

45



2. METHODOLOGY
2.1 Introduction

Several important aspects of the field study methodology are discussed below, including site
preparations, selection of the sweat collection device, data collection procedures, and the
laboratory analytical methods.

2.2. Site Preparations

ISA staff met with the PSA Laboratory Director in March 2001 for the purpose of making final
plans for the full field study. The design and general procedures of the study were discussed with
PSA officials with particular attention to specific locations for data collection and the procedures
by which subjects would be recruited. Afterward, the PSA Director provided a tour of PSA’s
various drug-testing and laboratory units, thus providing insight into their procedures and how the

’ field study operations dovetailed into those of PSA. Finally, it was agreed that data collection for
the field study would commence in early April 2001.

2.3 Selection of a Collection Device

As discussed from the literature and the pilot study, two sweat collection devices showed promise
for use in this project: the sweat patch and the LP collection device. The patch is FDA cleared for
drugs of abuse testing, and the LP collection system is FDA cleared for clinical applications such
as harvesting sweat for the diagnosis of cystic fibrosis. The sweat patch is a nonocclusive
collection device that has been developed specifically to harvest perspiration for testing for drugs
of abuse. The patches are approximately 5.1 cm x 7.6 cm (2 in x 3 in) and resemble large band-
aids. The patches have an outer hypoallergenic adhesive layer that is permeable to small
molecules, such as water vapor, and an absorbent pad. Each sweat patch has a unique identifier
for subject tracking, and the patch is tamper-resistant. The patch is attached to the subject’s upper
arm, chest, or lower back and typically is worn for 7 d to 14 d. While the patch is worn, drug(s)
and their metabolite(s) that are in the sweat are deposited on the pad. Several studies have shown
that the patches are particularly useful in criminal justice settings (Burns, 1995; Fogerson, et al.,
1997; and Kintz, 1996). These findings were validated in the pilot study, and the patch was
selected for comparison to LP and urine in the field study (Crouch, et al., 2001, and Crouch, et al.,
2002).

There were disadvantages to the commercial version of the LP collection system. The major
disadvantages were that it collected <100 pL of sweat, and the collection took up to 30 min.
Although the collection time appears protracted, it is not that much longer than the time required
for a urine collection when custody and control forms must be completed. The collection volume
was a problem given that drug screening usually requires 10 pL to 50 uL of sample/drug and MS
confirmations typically require 1 mL of sample/drug. It was important to minimize the collection
time and to maximize the volume of LP collected. Therefore, through improved testing methods,
discussions with the manufacturer, and the experimentation presented in the pilot study report, we
were able to improve the LP collection and the drug detection, and the modified collection device
was used in the field study.